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Steven Syrop (foreground) and his team conduct oral health examinations in Africa.
Steven Syrop (foreground) and his team conduct oral health examinations in Africa.
If asked to name the pressing health problems in Africa, most people might say “AIDS” or “malaria” or another infectious disease. But tooth pain? Cavities? It turns out that many in Africa have tooth problems that often go untreated and impact general health. When the Millennium Villages Project – created by Columbia’s Earth Institute to help eradicate poverty in sub-Saharan Africa – decided to add oral health to its overall health care goals for the region, a dentist from the College of Dental Medicine was eager to participate.
   Steven Syrop, D.D.S., an associate professor of dentistry with a longtime interest in humanitarian causes, along with Ian Zlotolow, D.M.D., of the International Society of Oral and Maxillofacial Rehabilitation, assembled a team and in the fall of 2006 traveled to the Ethiopian village of Koraro. Their goal: To determine prevailing oral health conditions among villagers and provide appropriate help.
   Koraro is one of several so-called “Millennium Villages” – those singled out for intervention by the Millennium Villages Project (MVP). Each Millennium Village is considered a “hunger hotspot,” selected for its location and for its potential to transmit successful anti-poverty strategies to nearby communities with similar problems. Each intervention must be low-tech, low-cost, sustainable, and culturally appropriate.
   The initial successes have been remarkable: After Koraro was established as the second Millennium Village in 2005 – the first was in Kenya in 2004 – simple agricultural techniques improved crop yields by more than 800 percent. The villagers built a health clinic and were assigned two health extension workers to address the basic healthcare needs of the village.
   In addition to Dr. Syrop and Dr. Zlotolow, the oral health team included College of Dental Medicine student Jeff Laughlin’08 who, after getting an M.P.H. from George Washington University, chose Columbia for dental school because he also has an interest in working with underserved populations. Peggy Timothe, D.D.S., M.P.H., from Harvard’s School of Dental Medicine and Khim Hean Teoh, B.D.S., M.D.S., from the National Hospital in Singapore, rounded out the team.
   Few Americans are acquainted with the abject poverty that is a daily fact of life for nearly half the population of sub-Saharan Africa. The chronic lack of health care, education, transportation, and infrastructure trap people in poverty, so the downward spiral continues with each generation. When Dr. Syrop and his team arrived in Koraro, they were not quite prepared for what they saw.
   “When you get there and find no electricity, no motorized vehicles and no uncontaminated water, you feel as though you have climbed down the economic ladder to the very lowest rung,” Dr. Syrop says.

Diagnosis: Poor Oral Health
After examining the villagers using a standardized World Health Organization dental assessment survey, the team discovered that most villagers had significant wearing-down of their teeth and were suffering. The wear on the teeth is caused by sand in the food, a result of the arid environment and lack of water for rinsing fruits and vegetables.
“Koraro is a perfect example of how widespread the problem of poor oral health actually is in many parts of Africa, due almost entirely to the poor economic situation,” says Mr. Laughlin. “We saw so many villagers in extreme pain from what was going on in their mouths.”
   Dr. Syrop says the plan to improve the villagers’ oral health – a plan that is still in the development stages – involves teaching health extension workers to extract teeth, control tooth infections and institute a prevention program. This involves the use of chewsticks – simple twigs that are chewed to clean teeth after eating. The next step is to integrate a prevention and maintenance program in the schools. More children will benefit from these dental interventions because more are attending school for the free hot lunches, available because of surplus crop yields resulting from the MVP’s agricultural initiatives. Building on previous interventions is a key to the success of the entire enterprise.
   Says Ira Lamster, D.D.S., dean of the College of Dental Medicine, who has supported the college’s involvement in this program: “This is another example of the importance our school places on global involvement. We have developed many affiliations with foreign schools in the past few years to train faculty in the latest dental techniques. The expertise of our dental faculty is increasingly sought after in many parts of the world, and they are interested and willing to go where they are needed.”
   The oral health component of the Millennium Villages Project has received a commitment for support from Bob Weinstein, co-founder with his brother Harvey of The Weinstein Group, an independent film studio.

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